NCC191004_Contact Update Record_20210423

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Selkane, Aziza 4/23/2021 5:48:07 PM (Contact Changes Submitted)

Certificate of NCC191004
Coverage (COC) Enter the Certificate of Coverage Ninber (Use capital letters)
No.*
NC Reference No. NCG01-2019-1004
Original NOI No.* 13580
Project information associated with this permit (cannot change):
Permittee Listed Organizaiton cannot be changed (new OOC required)
NASH Wendell Falls, LLC
Project Name
Wendell Valley Blvd.
Address
Knightdale Eagle Rock Road, Town of Wendell, NC
County
Wake
Latitude
35.7919
Longitude
-78.4265
Date COC Issued*
07/18/2019
Prior Rescission
This field will populate only if COChas already been rescinded.
Date
Which Contacts
f Billing Only
Have Changed?*
f Legally Responsible Individual Only
f Site Contact Only
r BOTH Legally Responsible Individual and Site Contact
Has Billing Contact
Choose'Yes'torevise Billing Contact details.
Changed?
r No
r Yes
Billing Email
NEW Billing Email [e-mail]
Billing Telephone
No.
NEW Billing 919-951-0716
Telephone No. (Optional)
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Garretson Browne
Individual
(Previous)

First Name (New)* Chris
Last Name (New) * Ferraguto
NEW Legally Reflects any revisions above
Responsible Chris Ferraguto
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee 919-819-9427
Telephone No.
(Previous)
NEW Permittee 919-951-0716
Telephone No.*
Permittee Mailing
4020 Westchase Boulevard, Suite 150,
Address (Previous)
Raleigh, NC 27607
NEW Permittee
Street Address
Mailing Address*
4020 Westchase Boulevard
Address Line 2
Suite 150
City
State / Rovince / Fbgion
Raleigh
NC
Fbstal / Zip Code
Country
27607
us
Permittee Street
4020 Westchase Boulevard, Suite 150,
Address (Previous)
Raleigh, NC 27607
NEW Permittee
Street Address
Street Address*
4020 Westchase Boulevard
Address Line 2
Suite 150
City
State / Rovince / Region
Raleigh
NC
Fbstal / Zip Code
Country
27607
us
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Garretson Browne
(Previous)
Site Contact Title Construction Manager
(Previous)
Organization NASH Wendell Falls, LLC
(Previous)

First Name (New)* Gareth
Last Name (New) * Avant
NEW Site Contact* Reflects any revisions above
Gareth Avant
NEW Site Contact Construction Manager
Title
NEW Organization
NASH Wendell Falls, LLC
This field is not required on the N01 form and may not pre -populate.
Site Contact Email
[e-mail]
(Previous)
NEW Site Contact
[e-mail]
Email *
Site Contact
919-819-9427
Telephone No.
(Previous)
NEW Site Contact
919-951-0716
Telephone No.*
Site Contact Mailing
4020 Westchase Boulevard, Suite 150,
Address (Previous)
Raleigh, NC 27607
NEW Site Contact
Street Address
Mailing Address*
4020 Westchase Boulevard
Address Line 2
Suite 150
City
State / province / Region
Raleigh
NC
Fbstal / Zip Code
Country
27607
us
Change Requested Chris Ferraguto
by: * Include any additional correspondence records in the Repository CDC folder.
Additional Information for this update to contact information:
Addional
Explanation
(Optional)
Date * 04/23/2021